| NPI | 1902261274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR Y LESLIE Owner 404-241-7062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain (Licence: GA 074690) |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2015-12-30 |